Active NPI
Emily Engelland Wilson, M.A.
- Psychologist
- Barboursville, WV
National Provider Identifier
1699889634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 752
- Practice address
- 105 River Rd
Barboursville, WV 25504-1205 - Phone
- (304) 302-2467
- Fax
- (304) 302-0215
- NPI assigned
- Aug 18, 2006
- Last updated
- Sep 10, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 752 | WV | Primary |
Addresses
Primary practice location
105 River Rd
Barboursville, WV 25504-1205
Mailing address
1218 9TH St
Huntington, WV 25701-3408
Phone (304) 697-5804
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0071720549 | Other | WV | BLUE CROSS/BLUE SHIELD |
| 9480068000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Previously, effective Aug 30, 2012 through Aug 30, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- Huntington, WV
- NPI 1811100597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284076800000",
"number": "1699889634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1218 9TH ST",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "257013408",
"telephone_number": "304-697-5804",
"fax_number": "304-302-0215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 RIVER RD",
"city": "BARBOURSVILLE",
"state": "WV",
"postal_code": "255041205",
"telephone_number": "304-302-2467",
"fax_number": "304-302-0215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "EMILY",
"middle_name": "ENGELLAND",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2010-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WV",
"license": "752",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "0071720549",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9480068000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Barboursville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.